Spy of the First
Person is a short semi-autobiographical narrative about a man with a
debilitating condition. He spends most
of his time sitting in a wheelchair on his porch, goes for tests to the Arizona
campus of the Mayo Clinic, and has a “handicapped sign hanging from the
rearview mirror of his car” (p. 15).
The man’s illness is unnamed, but we learn that his motor
skills are grossly impaired: “His hands and arms don’t work much. He uses his legs, his knees, his thighs, to
bring his arms and hands to his face in order to be able to eat his cheese and
crackers” (ibid).

The story is told from various, shifting points of
view. At times we are in the head of the
protagonist. At other times, the
perspective is that of a nosy neighbor who peers at the sick man through
binoculars, hence the book’s title. There is a parallel narrative about an
elderly couple and the wife’s gradual decline in health. The Southwest plays such an important role
here one might even say that it too is a character.

There are also frequent shifts of tense. It is not always clear whether we are in the
past or present. We alternate between the
central character’s fantasies, memories, and observations. The effect of intertwining
voices and tenses is reinforced by the brevity of the chapters, many no longer
than a paragraph. The overall impression
is that while he may no longer have full control over his body, the man has
retained an active (one might say overactive) mind.

Spy of the First
Person concludes as the man’s children take him to a Mexican restaurant. The vivid description of a meal shared with
his loved ones provides a sharp contrast to the inner thoughts that provide the
bulk of this book.

The play has two characters: Ruth and Friend (who is a male doctor).Ruth is an engaging, straight-talking quadriplegic who can zip and dance with her chin-operated wheelchair and takes delight in terrorizing medical staff both physically and verbally. She wants to write poetry and is waiting for a device to make it possible for her to use a computer. She keeps developing bedsores that threaten her life and require long admissions to the hospital before they will heal. She desperately wants to live no matter what happens, as she feels that having no mind would be worse than having no body.Friend is a male doctor with children who is ashamed of having examined her while she was unaware. Burdened with his guilt, he asks to be her “friend.” Ruth is skeptical and runs circles around him, but eventually comes to trust him and believe in his sincerity.She makes him a witness to her advance directive to instigate all heroic measures, as she is afraid of the kindly "ethical" and cost-effective arguments not to treat the disabled. But Ruth dies horribly from sepsis, and Friend is helpless to prevent it. She never obtains the device that would have allowed her to put her poems into printed words.

An artist, Ruth, lives with quadriplegia and manages to drive
(and dance) with a special wheelchair that she controls with her chin. She also
enjoys terrorizing doctors in the hospital corridors, where she is seen on a
regular basis because of frequent bouts of infected bedsores. She has a new
computer and is “patiently waiting for” a biomedical engineer to set it up to manage, like her chair, with her chin. She wants to write, to draw, to
create. But the wait list is long, technicians scarce, and every candidate
deserving.

On one of her admissions, Ruth meets the physician-narrator who is appalled by a medical resident’s lack of
empathy in relating her case as if she were not present. Distressed by the
encounter, the doctor is all the more disturbed when he notices that Ruth’s
birth date is the same as his own.

He tries to make it up to her by
withdrawing from her care in order to be her “friend,” one who tries to
understand and will defend her strong desire to live despite her disability. Driven
by curiosity about her past, her sharp wit, and how she faces each day, the
doctor never quite achieves his goal and constantly feels guilty for letting
her down as an advocate and a friend, and possibly also for being able-bodied
himself. He never visited her in her
group home, and when she comes to hospital in florid sepsis, he is unable to prevent
his colleagues from letting nature take its course. His own bout with severe
illness, possibly MS—more likely a stroke--resonates with Ruth’s plight. Long
after her death, he can imagine the acid remarks that she would make about his foibles.

Stitches is a beautifully
crafted graphic novel by award winning writer and illustrator David Small. The
memoir chronicles Smalls’ life with chronic illness, focusing on his experience as a child and adolescent
with cancer in the setting of an abusive upbringing. We learn through
the eyes of a child what being a patient is like, and how, despite all odds
Small was able to use art as a way to make a normal life for himself.

Dr. Monika Renz’s work with dying patients is unusual if not
unique in the way she appropriates and applies insights from Jungian depth
psychology, practices available in patients’ faith traditions, and musically
guided meditation to invite and support the spiritual experiences that so often
come, bidden or unbidden, near the end of life.
An experienced oncologist, Dr. Renz offers carefully amassed data to support
her advocacy of focused practices of spiritual care as a dimension of
palliative care, but is also quite comfortable with the fact that “neither the
frequency nor the visible effects of experiences of the transcendent prove that
such experience is an expression of grace” because “unverifiability is
intrinsic to grace.” Still, her long
experience leads her to assert not only that “grace” can be a useful,
practical, operative word for what professional caregivers may witness and
mediate but also that affirmation and support of patients’ spiritual,
religious, or transcendent experiences in the course of dying can amplify and
multiply moments of grace, which manifest as sudden, deep peace in the very
midst of pain, profound acceptance, openness to reconciliations, or significant
awakenings from torpor that allow needed moments of closure with loved ones. Describing herself as “an open-minded
religious person and a practicing Christian,” she reminds readers that God is a loanword, whose basic form in
Germanic was gaudam, a neutral
participle. Depending on the
Indo-Germanic root, the word means “the called upon” or “the one sacrificed to
. . . .” Openness to the divine in both
patients and caregivers, Dr. Renz argues, can and does make end-of-life care a
shared journey of discovery and offer everyone involved a valuable reminder that
medicine is practiced, always, at the threshold of mystery.

Victoria Sweet describes her training in medical school,
residency, and work in various clinics and hospitals. From all of these she
forms her own sense of what medical care should include: “Slow Medicine” that
uses, ironically, the best aspects of today’s “Fast” medicine.

Her dramatic “Introduction: Medicine Without a Soul” describes poor—even
dangerous—care given to her elderly father at a hospital. An experienced
physician, she calls Hospice and saves him from a “Death
Express” the hospital has “quality-assured” (pp. 6, 8).

The book continues with 16 chapters in chronological order. The first ten
describe Sweet from a late ‘60s Stanford undergrad and “a sort of hippie”
(p.14), next a learner of “facts” in preclinical studies at Harvard, plus the
clinical rotations (including Psychiatry, Internal Medicine, Pediatrics, and
electives), then an internship as a doctor and her work in various clinics and
hospitals. Throughout she’s collecting skills, concepts, even philosophies
(Jung, feminism, Chinese chi, value of stories). She also describes
particular patients important to her learning. She dislikes “just good enough”
medicine at the VA (p. 95), “unapologetic budgetarianism” (p 141), medicine
that is reductive and uncaring, and futile care for dying patients.
Halfway through, we find an “Intermission: In which Fast Medicine and Slow
Medicine Come Together.” With a year off, Sweet signs on as physician for a
trekking group headed for Nepal. Unexpectedly, she treats an Englishman in the
Himalayas. Returning home, she treats a man whose pulse is declining and rides
a helicopter with him to a hospital. She realizes that she can take on the full
responsibility of being a doctor, including when to use Fast medicine
and when to use Slow.

The following chapters deal with the 1980s emergence of AIDS, a hand injury to
Sweet (she sees herself as “a wounded healer,” p. 182), her new understanding
of medicine as “A Craft, A Science, and an Art” (Chapter 12) and conflicts between
medical care and economics-driven medicine (“checked boxes,” administrators,
quality assurance, even outright corruption). She scorns use of the
labels “health-care providers” and “health-care consumers” (p. 211) and
discovers Hildegard of Bingen’s medieval vision of medicine. She works for 20
years at Laguna Honda, the topic of her earlier book God’s Hotel(2012). Chapter 16 closes the book with “A Slow Medicine Manifesto.”

Sweet pays tribute to her teachers, both in a dedication to the book, and
throughout the pages: professors, preceptors, nurses—especially a series of
Irish Kathleens—and patients. There are some 20 case studies of patients
throughout the book, their medical dilemmas, their personalities, and Sweet’s Slow
Medicine that involves creating a healing relationship with them, finding the
right path for treatment, even watching and waiting.

Physician Ron Domen's first full-length poetry collection, "Plaintive Music," deserves, and requires, close and attentive reading. In these 47 poems, Domen favors short lines and keen attention to both sound and image.

The collection begins with the poet's observations of nature, primarily celebratory poems with lush descriptions and musical language, including poetic tributes to artist Charles Burchfield (pp. 1-6) and to Domen's father (pp.8-9).

Human life is often considered through the lens of woods and birds, gray slate and rain, naturally occurring elements that lead to memories of family and place ("Wooden Ties" p. 10 and "Cutting Wood with my Son" p. 14). Domen's images, which are rich and exact, often reflect his physician training and experiences. Consider these lines from "Woodturner" (p. 12). The poet is working a lathe, shaping a birch log into a bowl until "the white / grain streaked blue and brown / with minerals nursed from the earth / glows like the veined translucent / skin of a newborn child."

The middle section of "Plaintive Music" includes poems that examine the many facets of the poet's experiences as a physician, beginning with the wonderful "Studying Medicine in Guadalajara, Mexico: 1971-1975" (pp 17-22).

To read this powerful poem is to be there, driving to "the Queen City" five thousand feet high / in the Valley of Altemajac south / of the Tropic of Cancer" (p. 18), witnessing the lack of sophisticated cures ("No oxygen or drugs or IVs / and no machines to shock the heart / back to life only bare hands / pushed on his chest . . . " p. 19), "going door to door / to find the sick" (p. 20), and dissecting corpses pulled from a formaldehyde tank ("and each day scraped / and peeled away more flesh until nothing / was left to dissect and only / the bones remained" p. 22).

This poem is followed by a long poetic prose statement, "Belated Letter to a Mother," in which the narrator recalls a night thirty years ago when, as an internal medicine resident, he was called upon to care for a battered child and give witness to the complexities of human frailty. Embedded in the letter are a few lines that perfectly describe the role of the caregiver: "That sometimes all we can do is what the poet does-- "to see, to hear, to feel-- and more times than not, it is enough" (p. 25).

Poems on pages 17-36 especially gain power from the poet-physician's point of view. Final poems move again into the realm of nature, but here the themes are darker, reflecting the wages of learning to heal:

"I studied in medical school to learn / what actually lies under thick / layers of skin and how the heart / hides behind the breastplate" ("Armadillo" p. 33).

This collection comes full circle, beginning in "a time when flowers / had thoughts and the hills heard / turtles speak of the brilliant colors / of things growing" ("Beaver Creek" p. 1) and ending in winter, the darkest season, but not without its own beauty: "Snow begins to fall once again / on this windswept knoll along / the Lehigh River where the black // bony trees and dark gravestones / dot the slope of Nisky Hill" ("On Buying Our Gravesite" p. 61).

These poems are not a cancer chronicle, but the experience of living with cancer is threaded through them in a way that illustrates beautifully how awareness of illness may permeate daily life, but is foregrounded and backgrounded, reshaped and revisited in shifting ways as it takes its course. They encompass moments in family life, moments in the hospital, moments of spiritual longing and awareness of loss. Together they offer a record of accommodation, acclimation, and complex acceptance.

Taking Turns, Stories from HIV/AIDS Care Unit 371, is a graphic novel written and
illustrated by nurse and artist, MK Czerwiec. In it, she details what it was
like to be a nurse during the AIDs epidemic in Chicago in the 1990s. The book,
however, is much more than a story about AIDS care during that time. Czerweic
tackles patient/provider relationships, boundaries, hospital struggles, the
role of art in medicine and healing, but most profoundly: death and dying.

This Side of Doctoring is
an anthology published in 2002 about the experiences of women in medicine. While
the essays span multiple centuries, most are from the past 50 years. They reflect
on a multitude of stages in the authors’ personal and professional lives. In
344 pages divided into twelve sections, including "Early Pioneers,"
"Life in the Trenches," and "Mothering and Doctoring," the
146 authors recount - in excerpts from published memoirs, previously published
and unpublished essays, poems and other writings, many of them composed solely
for this collection - what it was then and what it was in 2002 to be a woman
becoming a doctor in the U.S.. All but a handful of the authors are physicians
or surgeons. There is a heavy representation from institutions on both coasts, especially
the Northeast. Four men were invited to reflect on being married to physician
wives. There is one anonymous essay concerning sexual harassment and a final essay
from a mother and daughter, both physicians.Beginning with the first American female physicians in the
mid-19th century, like historic ground-breakers Elizabeth Blackwell and Mary
Putnam Jacobi, the anthology proceeds through the phases of medical school,
residency, early and mid-careers, up to reflections from older physicians on a
life spent in medicine. Many of the authors have names well known in the
medical humanities, including Marcia Angell, Leon Eisenberg, Perri Klass,
Danielle Ofri, Audrey Shafer, and Marjorie Spurrier Sirridge, to mention a
few.

The essays and poems and letters have, as a partial listing, the following
subjects: family influences in becoming a physician; professional friendships; marriage;
children and their impact on a woman’s career in medicine; the decision not to
have children; ill family members; illness as a physician; establishing one's
sexuality as a physician; struggles with male physicians and their egos;
mentors, both female and male; memorable patients (often terminal or dying);
the life of a wife-physician, or mother-physician; the guilt and sacrifice that
accompany such a dual life; the importance - and easy loss - of personal time
or what internist Catherine Chang calls “self-care” (page 334).
The anthology also touches on how women have changed the
practice of medicine in various ways, prompted by the growing realization, as
family practice physician Alison Moll puts it, "that I didn't have to
practice in the traditional way" (page 185) The authors write about the wisdom of setting
limits; training or working part-time or sharing a position with another woman;
and the constant face-off with decisions, especially those not normally
confronting an American man becoming a doctor.
One conclusion is evident before the reader is halfway through the book: there
are many approaches to becoming a fulfilled female physician including finding
one’s identity in the field. Implicit in
most of the essays and writings is the lament from obstetrician-gynecologist
Gayle Shore Mayer: "Where is the self ? There are pieces
of me everywhere", (page 275) recalling a similar cry from Virginia
Woolf's Orlando, another essentially female soul trying to find what Richard
Selzer has called "The Exact Location of the Soul". Several authors discover that female physicians have
unique gifts to offer their patients. As internist Rebekah Wang-Cheng writes, “I
am a better physician because I am a mother, and I know because of my
experiences as a physician that I am a better mother.” (page 151)

There are sections at the end devoted to a glossary for the lay reader,
resources for women (as of 2002), and generous notes about the contributors
(which section also serves as a useful index of each's contributions).